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Kroener J, Maier A, Berger A, Sosic-Vasic Z. Coping with test anxiety using imagery rescripting: A two-session randomized controlled trial. J Affect Disord 2024; 356:554-563. [PMID: 38649104 DOI: 10.1016/j.jad.2024.04.067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 04/12/2024] [Accepted: 04/16/2024] [Indexed: 04/25/2024]
Abstract
BACKGROUND Up to 55 % of students experience test anxiety (TA), which is characterized by intense physiological and psychological symptoms before or during exams, such as anxiety, fear of failure, sweating, or increased heart rate. Furthermore, TA increases graduation times and can result in discontinuance of the graduate program all together. Previous research demonstrated the beneficial effects of combining cognitive behavioral therapy with imagery rescripting, however, treatment programs are comparably long. Hence, they do not account for the students´ time-sensitive schedules. Therefore, the present study investigates a two-session short-intervention using imagery rescripting to treat TA. METHODS 44 students and pupils were randomly assigned to either the two-session imagery rescripting intervention (22 participants) or the waitlist-control condition (22 participants). One week before the intervention clinical interviews were conducted and self-report questionnaires on TA, self-efficacy, symptoms of depression, and intrusive prospective images were completed (T1). The same questionnaires were completed one week (T2) and six months after the intervention (T3). RESULTS Test anxiety significantly decreased from T1 to T2, as well as from T1 to T3 within the intervention group. Furthermore, there were medium to large within and between group effects for situational test anxiety, self-efficacy, symptoms of depression, as well as prospective intrusive images, showing significant improvements for the intervention group at six months follow-up. LIMITATIONS The study is limited to the comparably small sample size, as well as the sole usage of self-report measurements. CONCLUSIONS The presented short-intervention provides a feasible treatment technique, which can be easily applied within school and university counseling centers.
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Affiliation(s)
- Julia Kroener
- Research Division for Applied Psychotherapy and Psychiatry, Christophsbad Hospital, Jahnstrasse 30, 73037 Goeppingen, Germany; Medical Faculty, University of Ulm, Helmholzstrasse 16, 89081 Ulm, Germany.
| | - Anna Maier
- Department for Psychiatry and Psychotherapy III, University Clinic of Ulm, Leimgrubenweg 12-14, 89075 Ulm, Germany
| | - Alexander Berger
- Department for Psychiatry and Psychotherapy III, University Clinic of Ulm, Leimgrubenweg 12-14, 89075 Ulm, Germany
| | - Zrinka Sosic-Vasic
- Research Division for Applied Psychotherapy and Psychiatry, Christophsbad Hospital, Jahnstrasse 30, 73037 Goeppingen, Germany; Medical Faculty, University of Ulm, Helmholzstrasse 16, 89081 Ulm, Germany
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Stavropoulos L, Briggs N, Grisham JR. Self-guided imagery rescripting for worry images: A preliminary experimental investigation. J Clin Psychol 2024; 80:1213-1230. [PMID: 38356250 DOI: 10.1002/jclp.23660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 07/30/2023] [Accepted: 01/29/2024] [Indexed: 02/16/2024]
Abstract
BACKGROUND Mental images of feared events are overactive and intrusive in generalized anxiety disorder (GAD). Imagery rescripting involves integration of positive or neutral imagery and corrective information into images to facilitate emotional processing, reduce imagery intrusions, and re-structure underlying schema. Yet only one known study has applied the technique to treatment of worry. The present study aimed first to examine the relationship between trait worry and properties of future-oriented worry images, and second to examine the efficacy of a self-guided imagery rescripting intervention in improving individuals' response to their worries. METHODS Participants recruited through Amazon Mechanical Turk (N = 365) identified their major worry and wrote the script of a worst-case scenario mental image. Participants were randomized to three conditions: re-writing the same worry image script (exposure), or writing scripts of either one or three positive alternative future-oriented images (rescripting conditions). RESULTS In preliminary analyses, trait worry negatively predicted participants' ratings of worry images, including valence and ability to cope, and positively predicted distress, anticipated cost, and belief in their negative meaning. In experimental analyses, linear mixed-effects models revealed anxious response and cognitive appraisal of the threat were significantly lower among participants allocated to rescripting relative to exposure. There was no effect of rescripting type. CONCLUSIONS This investigation demonstrated the impact of a future-oriented imagery rescripting task on anxiety and cognitive biases associated with real worries in an unselected sample. Results may contribute to the development of imagery rescripting interventions for GAD.
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Affiliation(s)
| | - Nancy Briggs
- Stats Central, Mark Wainwright Analytical Centre, University of New South Wales, Sydney, Australia
| | - Jessica R Grisham
- School of Psychology, University of New South Wales, Sydney, Australia
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Benke C, Wallenfels LM, Bleichhardt GM, Melzig CA. Health anxiety amplifies fearful responses to illness-related imagery. Sci Rep 2024; 14:4345. [PMID: 38388793 PMCID: PMC10883981 DOI: 10.1038/s41598-024-54985-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Accepted: 02/19/2024] [Indexed: 02/24/2024] Open
Abstract
Severe health anxiety (HA) is characterized by excessive worry and anxiety about one's health, often accompanied by distressing intrusive imagery of signs of a serious illness or potentially receiving bad news about having a life-threatening disease. However, the emotional responses to these illness-related mental images in relation to HA have not been fully elucidated. Emotional responses to mental imagery of 142 participants were assessed in a well-controlled script-driven imagery task, systematically comparing emotional responses to illness-related imagery with neutral and standard fear imagery. The results revealed that participants reported higher anxiety, aversion, emotional arousal, and a stronger avoidance tendency during imagery of fear and illness-related scenes compared to neutral scenes. Importantly, the emotional modulation varied by the level of HA, indicating that individuals with higher HA experienced stronger emotional responses to illness-related imagery. This association between HA and fearful imagery could not be better accounted for by other psychological factors such as trait anxiety, anxiety sensitivity, somatic symptom severity, or symptoms of depression and anxiety. Fearful responding to standard threat material was not associated with HA. The present findings highlight the importance of considering fear responding to mental imagery in understanding and addressing HA.
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Affiliation(s)
- Christoph Benke
- Department of Psychology, Clinical Psychology and Psychotherapy, Philipps University of Marburg, Gutenbergstraße 18, 35032, Marburg, Germany.
| | - Laura-Marie Wallenfels
- Department of Psychology, Clinical Psychology and Psychotherapy, Philipps University of Marburg, Gutenbergstraße 18, 35032, Marburg, Germany
| | - Gaby M Bleichhardt
- Department of Psychology, Clinical Psychology and Psychotherapy, Philipps University of Marburg, Gutenbergstraße 18, 35032, Marburg, Germany
| | - Christiane A Melzig
- Department of Psychology, Clinical Psychology and Psychotherapy, Philipps University of Marburg, Gutenbergstraße 18, 35032, Marburg, Germany
- Center for Mind, Brain and Behavior (CMBB), University of Marburg and Justus Liebig University Giessen, Giessen, Germany
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Ghosh A, Cohen KA, Jans L, Busch CA, McDanal R, Yang Y, Cooper KM, Schleider JL. A Digital Single-Session Intervention (Project Engage) to Address Fear of Negative Evaluation Among College Students: Pilot Randomized Controlled Trial. JMIR Ment Health 2023; 10:e48926. [PMID: 37995114 DOI: 10.2196/48926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 09/15/2023] [Accepted: 10/06/2023] [Indexed: 11/24/2023] Open
Abstract
BACKGROUND Increasingly, college science courses are transitioning from a traditional lecture format to active learning because students learn more and fail less frequently when they engage in their learning through activities and discussions in class. Fear of negative evaluation (FNE), defined as a student's sense of dread associated with being unfavorably evaluated while participating in a social situation, discourages undergraduates from participating in small group discussions, whole class discussions, and conversing one-on-one with instructors. OBJECTIVE This study aims to evaluate the acceptability of a novel digital single-session intervention and to assess the feasibility of implementing it in a large enrollment college science course taught in an active learning way. METHODS To equip undergraduates with skills to cope with FNE and bolster their confidence, clinical psychologists and biology education researchers developed Project Engage, a digital, self-guided single-session intervention for college students. It teaches students strategies for coping with FNE to bolster their confidence. Project Engage provides biologically informed psychoeducation, uses interactive elements for engagement, and helps generate a personalized action plan. We conducted a 2-armed randomized controlled trial to evaluate the acceptability and the preliminary effectiveness of Project Engage compared with an active control condition that provides information on available resources on the college campus. RESULTS In a study of 282 upper-level physiology students, participants randomized to complete Project Engage reported a greater increase in overall confidence in engaging in small group discussions (P=.01) and whole class discussions (P<.001), but not in one-on-one interactions with instructors (P=.05), from baseline to immediately after intervention outcomes, compared with participants in an active control condition. Project Engage received a good acceptability rating (1.22 on a scale of -2 to +2) and had a high completion rate (>97%). CONCLUSIONS This study provides a foundation for a freely available, easily accessible intervention to bolster student confidence for contributing in class. TRIAL REGISTRATION OSF Registries osf.io/4ca68 http://osf.io/4ca68.
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Affiliation(s)
- Arka Ghosh
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
- Center for Behavioral Intervention Technologies, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Katherine A Cohen
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Laura Jans
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Carly A Busch
- Research for Inclusive STEM Education Center, School of Life Sciences, Arizona State University, Tempe, AZ, United States
| | - Riley McDanal
- Department of Psychology, Stony Brook University, Stony Brook, NY, United States
| | - Yuanyuan Yang
- Department of Psychology, University of Kansas, Lawrence, KS, United States
| | - Katelyn M Cooper
- Research for Inclusive STEM Education Center, School of Life Sciences, Arizona State University, Tempe, AZ, United States
| | - Jessica L Schleider
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
- Center for Behavioral Intervention Technologies, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
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Moscovitch DA, Moscovitch M, Sheldon S. Neurocognitive Model of Schema-Congruent and -Incongruent Learning in Clinical Disorders: Application to Social Anxiety and Beyond. PERSPECTIVES ON PSYCHOLOGICAL SCIENCE 2023; 18:1412-1435. [PMID: 36795637 PMCID: PMC10623626 DOI: 10.1177/17456916221141351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
Negative schemas lie at the core of many common and debilitating mental disorders. Thus, intervention scientists and clinicians have long recognized the importance of designing effective interventions that target schema change. Here, we suggest that the optimal development and administration of such interventions can benefit from a framework outlining how schema change occurs in the brain. Guided by basic neuroscientific findings, we provide a memory-based neurocognitive framework for conceptualizing how schemas emerge and change over time and how they can be modified during psychological treatment of clinical disorders. We highlight the critical roles of the hippocampus, ventromedial prefrontal cortex, amygdala, and posterior neocortex in directing schema-congruent and -incongruent learning (SCIL) in the interactive neural network that comprises the autobiographical memory system. We then use this framework, which we call the SCIL model, to derive new insights about the optimal design features of clinical interventions that aim to strengthen or weaken schema-based knowledge through the core processes of episodic mental simulation and prediction error. Finally, we examine clinical applications of the SCIL model to schema-change interventions in psychotherapy and provide cognitive-behavior therapy for social anxiety disorder as an illustrative example.
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Affiliation(s)
- David A. Moscovitch
- Department of Psychology and Centre for Mental Health Research & Treatment, University of Waterloo
| | - Morris Moscovitch
- Rotman Research Institute and Department of Psychology, Baycrest Centre for Geriatric Care
- Department of Psychology, University of Toronto
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Kroener J, Hack L, Mayer B, Sosic-Vasic Z. Imagery rescripting as a short intervention for symptoms associated with mental images in clinical disorders: A systematic review and meta-analysis. J Psychiatr Res 2023; 166:49-60. [PMID: 37738780 DOI: 10.1016/j.jpsychires.2023.09.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 07/11/2023] [Accepted: 09/15/2023] [Indexed: 09/24/2023]
Abstract
There is an unmet need for effective short-term therapeutic techniques to reduce clinical symptoms associated with prospective-, as well as retrospective aversive mental images across mental disorders. We investigated the efficacy of imagery rescripting (IR) as a short-term intervention across clinical disorders, as the literature suggests that this technique could be a promising intervention to reduce psychopathology by altering intrusive mental images. A systematic literature review identified 23 trials including 805 adult patients, out of which 15 trials were designed as randomized controlled trials (RCT) including patients with the following diagnoses: Social anxiety disorder (SAD), Posttraumatic-Stress-Disorder (PTSD), Bulimia Nervosa, Borderline Personality Disorder, Obsessive-Compulsive Disorder, nightmare disorder, test anxiety, health anxiety, and Generalized Anxiety Disorder. Most studies (14) comprised of one treatment session. Effect size estimates indicate that IR is highly effective in reducing clinical symptoms associated with mental images from pre-, to post-treatment (g = 1.09, 95% CI = [0.64; 1.53]), as well as from pre-treatment to follow-up (g = 1.90, 95% CI = [1.02; 2.77]). Comparing the IR intervention to a passive control group showed large effect sizes at post-treatment (g = -0.99; 95% CI = [-1.79; -0.20]), however, comparing IR to an active control group resulted in a small effect (g = -0.05; 95% CI = [-0.43; 0.33]). Lastly, large effects of IR were found for the SAD and PTSD subgroups, for comorbid symptoms of depression. In summary, our results indicate that IR is a promising short-term therapeutic technique for clinical symptoms associated with aversive prospective-, and retrospective mental images.
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Affiliation(s)
- Julia Kroener
- Department of Applied Psychotherapy and Psychiatry, Christophsbad Goeppingen, Jahnstraße 30, 73037, Goeppingen, Germany; Medical Department, University of Ulm, Albert-Einstein-Allee 11, 89081, Ulm, Germany.
| | - Lisa Hack
- Department of Applied Psychotherapy and Psychiatry, Christophsbad Goeppingen, Jahnstraße 30, 73037, Goeppingen, Germany; Medical Department, University of Ulm, Albert-Einstein-Allee 11, 89081, Ulm, Germany
| | - Benjamin Mayer
- Institute for Epidemiology and Medical Biometry, University of Ulm, Schwabstraße 13, 89075, Ulm, Germany
| | - Zrinka Sosic-Vasic
- Department of Applied Psychotherapy and Psychiatry, Christophsbad Goeppingen, Jahnstraße 30, 73037, Goeppingen, Germany; Medical Department, University of Ulm, Albert-Einstein-Allee 11, 89081, Ulm, Germany
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Kip A, Schoppe L, Arntz A, Morina N. Efficacy of imagery rescripting in treating mental disorders associated with aversive memories - An updated meta-analysis. J Anxiety Disord 2023; 99:102772. [PMID: 37699277 DOI: 10.1016/j.janxdis.2023.102772] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Revised: 08/09/2023] [Accepted: 09/03/2023] [Indexed: 09/14/2023]
Abstract
Imagery rescripting (ImRs) is frequently applied to treat different psychological complaints. We conducted an updated meta-analysis based on randomised controlled trials on the efficacy of ImRs for mental disorders associated with aversive memories. Medline, PsycInfo, and Web of Science were searched up to May 2023. Seventeen trials were included with a total of 908 participants (417 in the ImRs condition), suffering from posttraumatic stress disorder, anxiety disorders, depression, or eating disorders. Random effect models yielded an overall effect of g = 0.68 (95 % CI 0.18 to 1.18; k = 7) compared to passive controls (mostly waitlist). The effect compared to (prolonged) exposure, cognitive restructuring, and EMDR was non-significant (g = -0.01; 95 % CI -0.18 to 0.15; k = 11). Follow-up assessments indicated a long-term treatment effect. Results suggest that ImRs can effectively treat a variety of psychological disorders and produce similar treatment effects as evidence-based interventions. Limitations include the bounded number of included trials for each mental disorder. The meta-analysis was registered on PROSPERO (CRD42020220696) and received no funding.
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Affiliation(s)
- Ahlke Kip
- Institute of Psychology, University of Münster, Fliednerstraße 21, 48149 Münster, Germany.
| | - Luisa Schoppe
- Institute of Psychology, University of Münster, Fliednerstraße 21, 48149 Münster, Germany
| | - Arnoud Arntz
- Department of Clinical Psychology, University of Amsterdam, Nieuwe Achtergracht 129, 1018 WS Amsterdam, the Netherlands
| | - Nexhmedin Morina
- Institute of Psychology, University of Münster, Fliednerstraße 21, 48149 Münster, Germany
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Norton AR, Penney E, Abbott MJ. An exploratory investigation of schema modes in social anxiety disorder: Empirical findings and case conceptualization. J Clin Psychol 2023; 79:1021-1038. [PMID: 36383710 DOI: 10.1002/jclp.23457] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 07/05/2022] [Accepted: 11/01/2022] [Indexed: 11/17/2022]
Abstract
BACKGROUND Current "gold standard" treatments for social anxiety disorder (SAD) are limited by the limited emphasis of key etiological factors in conceptualization, and many individuals with SAD experience residual symptoms posttreatment. Hence, the novel application of the Schema Therapy Mode Model may provide a helpful framework for extending clinical understanding and treatment options for SAD. This exploratory study aimed to investigate the presence and pattern of schema modes among SAD individuals. METHOD Forty individuals with SAD completed questionnaire measures of symptomatology, social anxiety-relevant cognitions, schema modes, childhood trauma, and parental style. RESULTS Key maladaptive schema modes identified in SAD were Vulnerable Child, Punitive Critic, Demanding Critic, Compliant Surrender, and Detached Self-Soother. CONCLUSION Outcomes provide the basis for a proposed schema mode case conceptualization for SAD and are hoped to provide a rationale for testing the applicability of Schema Therapy as a novel treatment for SAD. Key limitations are discussed.
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Affiliation(s)
- Alice R Norton
- Clinical Psychology Unit, School of Psychology, The University of Sydney, Sydney, Australia.,Graduate School of Health, University of Technology Sydney, Sydney, Australia
| | - Erika Penney
- Graduate School of Health, University of Technology Sydney, Sydney, Australia
| | - Maree J Abbott
- Clinical Psychology Unit, School of Psychology, The University of Sydney, Sydney, Australia
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Luoma JB, Shahar B, Kati Lear M, Pilecki B, Wagner A. Potential processes of change in MDMA-Assisted therapy for social anxiety disorder: Enhanced memory reconsolidation, self-transcendence, and therapeutic relationships. Hum Psychopharmacol 2022; 37:e2824. [PMID: 34739165 PMCID: PMC9285360 DOI: 10.1002/hup.2824] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 10/04/2021] [Indexed: 01/08/2023]
Abstract
OBJECTIVE Researchers have suggested that psychotherapy may be enhanced by the addition of 3,4-methylenedioxymethamphetamine (MDMA), particularly in the treatment of disorders wherein interpersonal dysfunction is central, such as social anxiety disorder. We review literature pertaining to three potential processes of change that may be instigated during sessions involving MDMA administration in the treatment of social anxiety disorder. DESIGN This is a narrative review that integrates research on the etiology and maintenance of social anxiety disorder and mechanisms of action of MDMA to examine how MDMA may enhance psychotherapy outcomes. RESULTS We first outline how MDMA may enhance memory reconsolidation in social anxiety disorder. We then discuss how MDMA may induce experiences of self-transcendence and self-transcendent emotions such as compassion, love, and awe; and how these experiences may be therapeutic in the context of social anxiety disorder. We subsequently discuss the possibility that MDMA may enhance the strength and effectiveness of the therapeutic relationship which is a robust predictor of outcomes across many disorders as well as a potential key ingredient in treating disorders where shame and social disconnection are central factors. CONCLUSION We discuss how processes of change may extend beyond the MDMA dosing sessions themselves.
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Affiliation(s)
- Jason B. Luoma
- Portland Psychotherapy Clinic, Research, & Training CenterPortlandOregonUSA
| | - Ben Shahar
- The Hebrew University of JerusalemJerusalemIsrael
| | - M. Kati Lear
- Portland Psychotherapy Clinic, Research, & Training CenterPortlandOregonUSA
| | - Brian Pilecki
- Portland Psychotherapy Clinic, Research, & Training CenterPortlandOregonUSA
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Lloyd J, Marczak M. Imagery rescripting and negative self-imagery in social anxiety disorder: a systematic literature review. Behav Cogn Psychother 2022; 50:1-18. [PMID: 35225202 DOI: 10.1017/s135246582200008x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Imagery rescripting (IR) is an effective intervention for social anxiety disorder (SAD) that targets memories of distressing formative events linked to negative self-imagery (NSI). IR is thought to update unhelpful schema by addressing the needs of the younger self within the memory. An accumulating body of evidence indicates that by modifying NSI, IR can significantly affect distressing imagery, memory appraisal, and beliefs about the self. AIMS This systematic review aims to critically evaluate and synthesise literature investigating the existing research on the effects IR has on NSI in SAD. METHOD A systematic electronic search of Academic Search Complete, ProQuest, Medline, Scopus and PubMed was performed in February 2021 using pre-defined criteria. Ten studies met the inclusion criteria and were selected for review. RESULTS Analysis of the reviewed articles' findings identified three main themes: Changes to negative self-images, Memories linked to images and Encapsulated beliefs. IR was associated with significant decreases in image distress, image vividness, memory vividness, memory distress, and encapsulated beliefs. Although reductions were found with image frequency, they were non-significant. Interpretation of results is limited by the small number of studies. CONCLUSIONS IR appears to effectively alter images, memories and beliefs in SAD in as little as a single session. The findings indicate that IR could be utilised as a cost-effective intervention for SAD. However, additional studies and longer-term follow-ups are needed.
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Affiliation(s)
- James Lloyd
- School of Psychological, Social and Behavioural Sciences, Faculty of Health and Life Sciences, Coventry University, Priory Street, CoventryCV1 5FB, UK
| | - Magda Marczak
- School of Psychological, Social and Behavioural Sciences, Faculty of Health and Life Sciences, Coventry University, Priory Street, CoventryCV1 5FB, UK
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Penney ES, Norton AR. A Novel Application of the Schema Therapy Mode Model for Social Anxiety Disorder: A Naturalistic Case Study. Clin Case Stud 2021. [DOI: 10.1177/15346501211027866] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Social Anxiety Disorder (SAD) is a condition defined by an excessive and persistent fear of negative evaluation in social or performance situations. Whilst Cognitive Behaviour Therapy (CBT) is the gold standard treatment, not all individuals with SAD respond to CBT. The Schema Therapy Mode Model is frequently applied to chronic and hard-to-treat conditions and therefore may be applicable for SAD individuals who are non-responders to CBT. This case study describes how the Mode Model was successfully used to treat a woman in her 20s who presented with excessive fears of negative evaluation and pervasive social avoidance. Experiential techniques, such as chair dialogues and imagery rescripting, resulted in cognitive modification of negative core beliefs, reduced experiential discomfort and increased engagement in social and relational activities. This case offers a preliminary indication that the Schema Therapy Mode Model may be an effective treatment for socially anxious individuals and that further theoretical and empirical study in this area is warranted.
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Rescripting Social Trauma: A Pilot Study Investigating Imagery Rescripting as an Adjunct to Cognitive Behaviour Therapy for Social Anxiety Disorder. COGNITIVE THERAPY AND RESEARCH 2021. [DOI: 10.1007/s10608-021-10221-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Paulik G, Maloney G, Arntz A, Bachrach N, Koppeschaar A, McEvoy P. Delivering Imagery Rescripting via Telehealth: Clinical Concerns, Benefits, and Recommendations. Curr Psychiatry Rep 2021; 23:24. [PMID: 33725200 PMCID: PMC7962431 DOI: 10.1007/s11920-021-01238-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/23/2021] [Indexed: 02/01/2023]
Abstract
PURPOSE OF THE REVIEW Delivery of psychological therapies via telehealth has increased with the emergence of the COVID-19 pandemic. Therapists may be hesitant in moving to telehealth when delivering therapies targeting memories of traumatic experiences. This paper collates the clinical experiences of clinicians and clients who have delivered or received imagery rescripting, respectively, via telehealth across a range of clinical presentations, and describes key clinical considerations and recommendations. RECENT FINDINGS It is important to consider perceived and real safety; practical and technological issues; therapeutic alliance; depth of emotional processing; and dissociation. There was support for the delivery of imagery rescripting via telehealth being no less effective than face-to-face delivery; however, telehealth delivery was not a viable option for many clients during COVID-19 lockdowns who were living in high density housing, old houses with thin walls, or with some complex disorders.
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Affiliation(s)
- Georgie Paulik
- Perth Voices Clinic, School of Psychology, Murdoch University, 90 South Street, Murdoch, Western Australia, 6150, Australia.
- School of Psychological Science, University of Western Australia, Crawley, Australia.
- School of Psychology and Exercise Science, Murdoch University, Murdoch, Australia.
| | - Gayle Maloney
- Perth OCD Clinic, West Perth, Australia
- Yale OCD Research Clinic, Yale University School of Medicine, New Haven, USA
| | - Arnoud Arntz
- Department of Clinical Psychology, University of Amsterdam, Amsterdam, Netherlands
| | - Nathan Bachrach
- GGZ Oost Brabant, Boekel, Netherlands
- RINO ZUID, Eindhoven, Netherlands
- Tilburg University, Tilburg, Netherlands
| | | | - Peter McEvoy
- School of Psychology, Curtin University, Perth, Australia
- Centre for Clinical Interventions, Northbridge, Australia
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Imagery Rescripting for Anxiety Disorders and Obsessive-Compulsive Disorder: Recent Advances and Future Directions. Curr Psychiatry Rep 2020; 22:17. [PMID: 32076845 DOI: 10.1007/s11920-020-1139-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
PURPOSE OF REVIEW This review describes imagery rescripting (ImRs) and its clinical application to anxiety disorders and obsessive-compulsive disorder (OCD). Variations in ImRs delivery, clinical evidence, and theories of potential mechanisms of change are also reviewed. Finally, we propose a future research agenda. RECENT FINDINGS There is some evidence that ImRs affects memory processes and schemas. ImRs is associated with reductions in cognitive-affective, physiological and behavioural symptoms of social anxiety disorder and reductions in OCD-related distress and OCD symptoms. ImRs for other anxiety disorders has not been evaluated. While ImRs appears to be an effective intervention for social anxiety disorder and OCD, more research is needed to (a) systematically compare ImRs to established interventions, (b) evaluate ImRs for other anxiety disorders, (c) test theorized mechanisms of change, and (d) evaluate the impact of moderating factors and treatment variations on therapeutic outcomes.
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